“Contact tracing was put into place at the White House immediately after Trump aide Hope Hicks tested positive for coronavirus, White House press secretary Kayleigh McEnany said on Friday…
In separate remarks to reporters, McEnany said it was considered safe for Trump to travel to his resort in Bedminster, New Jersey, for a private fundraiser on Thursday.
“It was deemed safe for the president to go. He socially distanced, it was an outdoor event and it was deemed safe by White House operations for him to attend that event,” she said.” (A)
President Donald Trump’s big-dollar fundraiser at his New Jersey golf club went on as planned Thursday night despite the President and staff knowing he had been exposed to coronavirus.
Trump attended three events at the fundraiser: an indoor roundtable, an indoor VIP reception — donors had a socially distant photo opportunity with him — and an outdoor reception, according to an event invitation obtained by CNN.
Donors that gave $250,000 were able to participate in a roundtable, photo opportunity and reception with the President, according to the event invite. The roundtable included 18 donors, according to a source, and was held indoors at socially-distanced tables.
Another source says that the attendees at the roundtable were tested for coronavirus when they arrived and that no one wore masks.
Three attendees told CNN that most people at the events were not wearing masks; all three say they have not been contacted by any contact tracers….
An hour and a half before the fundraiser, some senior staff and the President were informed Hope Hicks had tested positive for coronavirus, White House chief of staff Mark Meadows told reporters on Friday.
The decision was made to still hold the fundraiser despite Trump’s exposure; attendees say they were not notified the President had been exposed to Covid-19…
On Friday at noon, the Trump campaign emailed attendees officially notifying them the President tested positive for coronavirus.
“We unfortunately write today to notify you that, as you have probably seen, President Trump confirmed late last night that he and the First Lady were tested for COVID-19 and produced positive test results,” the email, obtained by CNN, reads. “Out of an abundance of caution, we want to call this to your attention.”
The email went on to encourage attendees to contact their medical provider if they, or their loved ones, develop Covid-19 symptoms. It did not make any mention of quarantining or self-isolation but did recommend attendees visit the CDC’s website.” (B)
“With President Donald Trump’s positive coronavirus test, the White House is now ground zero for the most closely watched contact tracing exercise of the Covid-19 pandemic in the US….
How big could the cluster of infections around Trump grow? The only way to figure it out is contact tracing: identifying who has been in close contact with the president since he became contagious, and asking them to quarantine to prevent Covid-19 from spreading to others, and to get tested themselves. We also aren’t sure what kinds of tests the Trump administration is using, and that makes a difference in figuring out who else might be exposed.
Testing for Covid-19, tracing people who may have been exposed, and getting them to isolate is the backbone of an effective coronavirus response. It’s also a program that the US has largely failed to execute effectively but which is now of utmost importance to the continued health of our nation’s leaders and those around them.
Ashish K. Jha, dean of the Brown University School of Public Health, laid out in a brief Twitter thread what should happen now, and the challenges that will make contact tracing difficult even at the White House.
This is the first difficulty: People who have contracted the coronavirus and are contagious still might not show symptoms for several days. As Muge Cevik, a virologist at the University of St. Andrews, laid out on Twitter recently, people with Covid-19 generally start to become more infectious in the two days before their symptoms start and then for a week afterward.
So Jha recommended: “Everyone who has been near the President at least from Saturday on needs to be identified.” But that is, as he acknowledged, easier said than done.
Contact tracing, in non-pandemic times, is typically concentrated on sexually transmitted diseases. Generally speaking, people know whom they’ve had sexual contact with; so while these can be sensitive discussions, there is not much confusion about who may have been exposed to HIV or syphilis.
But an airborne virus like Covid-19 is much more difficult to trace. The general rule of thumb, public health workers have told me previously, is you want to identify anybody who has been within 6 feet of an infected person for a period of 15 minutes or more….
So this work of testing, tracing, and isolating is already underway, because the president and senior government leaders being exposed to a deadly pathogen is rightfully seen as a national emergency. This is the right response after learning a person who is in contact with a lot of people has contracted the coronavirus.
But the US has also struggled to implement a test-trace-isolate program more broadly, despite strong expert consensus that it’s the best way to get the pandemic under control.” (C)
….”As you read this, Trump’s immediate contacts are being identified and contacted. Those who got close to Trump after he was infected will need to go into quarantine, defined as a 14-day period of having no contact with anyone, regardless of whether they develop symptoms.
It sounds straightforward in theory—but in practice, it’s a lot harder. When we talk about contact tracing for Trump’s potential Covid-19 exposure, what we really mean is identifying the people who’ve been exposed to Trump in a handful of specific ways, between the time that he encountered the virus and the time that he tested positive. And that’s where things get a little messy.
When did infection happen?
It’s hard to pin down when someone was initially infected with Covid-19 because of the nature of how SARS-CoV-2 enters the body: slowly, one cellular ACE2 receptor at a time, which can trick individuals into thinking they’re healthy even after they’ve been infected.
On average, “you have two days of incubation, in which a PCR test wouldn’t test the virus,” says Brooke Nichols, a health economist at Boston University who uses mathematical models to map infectious spread. During these two days, a person likely wouldn’t have enough of a viral load to infect others.
Then, however, most people enter a pre-symptomatic phase. This is the danger zone: A person is sick, still not showing symptoms, but has enough of a viral load to potentially infect others. This when people are most likely to give the virus to others. Once a person does have symptoms, they’re (usually) wise enough to get tested, tell others, and isolate.
Based on what we know about the appearance of Trump’s symptoms and the test he took on Oct. 1 that came back positive, he could have been exposed, infected, and contagious to others as early as the beginning of the week…
At the moment, no one knows—though hours before Trump announced he had Covid-19 on Twitter, Bloomberg reported that one of his senior aides, Hope Hicks, tested positive. On Sept. 29 Hicks had been aboard Air Force one with Trump and others as he traveled to the debate in Cleveland, and then to Minnesota for a campaign rally. She reportedly felt sick in Minnesota, so isolated herself on the plane ride home.
That means Hicks could have given Trump Covid-19. But given that they tested positive around the same time, it’s possible that one person exposed both of them, says Gurley. And that possibility introduces the need for a totally different approach to contact tracing—not just in the White House, but in general.
Identifying, quarantining, and potentially testing every one of Trump’s contacts in the last week, when it was likely he was exposed—the traditional contact tracing approach—would successfully squash any outbreaks that stem from him, alone. But it wouldn’t stop any outbreaks that started with the person who infected Trump.
A different approach would attempt to identify the missing link between a growing number of positive cases connected to the White House. If we could trace all of their contacts backwards in time, we could potentially identify an infected person who exposed them all… (D)
“The White House has yet to deploy a specialist Centers for Disease Control and Prevention (CDC) team to track and test those whom President Donald Trump came into contact with after being infected with the coronavirus.
Two sources told The Washington Post Saturday that the CDC specialists’ team was on standby but had not yet begun to work tracing all of those the president came into contact with while infected.” (E)
In the days immediately preceding President Donald Trump’s COVID-19 diagnosis, he and his aides travelled to five states, holding several rallies and crowded indoor events with large groups of people. But there’s no clear indication that the White House is playing its stated role as the coordinator of a critical contact tracing effort that could help stem the spread of the virus, according to local and state health officials.
At a press conference on Oct. 3, Trump’s personal physician said the White House was at the center of the contact tracing effort. “The White House medical unit, in collaboration with CDC and local state and health departments, are conducting all contact tracing per CDC guidelines,” said White House physician Dr. Sean Conley.
But in response to questions from TIME, local and state health officials in many of the locations that Trump recently visited indicated the Trump Administration has taken few evident steps on contact tracing to date. Officials in four states—Minnesota, Pennsylvania, New Jersey and Virginia—stated or suggested they had not been contacted by the Trump campaign. Officials with the city of Cleveland, where the presidential debate was held Sept. 29, did not respond to an inquiry, and the Cleveland Clinic declined to comment on that topic.
In response to a TIME inquiry about contact tracing, the Trump campaign pointed to Conley’s comment saying the White House Medical Unit was doing the tracing. The Centers for Disease Control and Prevention (CDC) referred TIME to the White House, which said the White House Medical Unit was doing contact tracing in coordination with CDC personnel.” (F)
“Public health officials in the cities and states that President Trump visited in recent days are working to contact those who were in close proximity to him, first lady Melania Trump and others who traveled with him.
Since he has tested positive for the coronavirus, health officials worry those who attended events with the president could be at risk for the virus, too.
Over the past two weeks, Trump attended events in Florida, Georgia, Pennsylvania and Minnesota as well as a fundraiser in New Jersey and, of course, the presidential debate in Cleveland. He also went to his golf club in Potomac Falls, Va., and hosted an event announcing his Supreme Court nominee Amy Coney Barrett at the White House…
The president’s rally was held on the tarmac of Duluth International Airport, where according to Minnesota Public Radio, thousands of people attended, including many who didn’t distance themselves from each other or wear face masks, with the notable exception of those behind the stage and in camera view.
The Minnesota Department of Health is offering guidance to those who attended the rally, too, warning that community transmission of COVID-19 in the Duluth area was already high before the campaign event, “and people attending the rally may have been infectious without realizing it.”
Before Wednesday’s campaign rally, Trump attended an afternoon GOP fundraiser at a private home in Shorewood, Minn., a suburb of Minneapolis-St. Paul.
Minnesota Republican Party Chair Jennifer Carnahan said in a statement that about 40 people attended that fundraiser but that she did not meet with Trump.
“I have not been in contact with any of the donors who had been at that event,” she said. “My understanding as well, they were all required to take a negative COVID test with results within 24 hours of the president’s visit to donors, and it is also my understanding that people were not allowed to shake hands or come into that close of contact with the president while he was there.”..
In an interview with Minnesota Public Radio, Dr. Michael Osterholm, an epidemiologist and director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said he was alarmed by reports that some who attended the president’s events think they can be tested once and be in the clear.
“I’m a little disturbed by the fact that I heard some of the individuals who are exposed in the last 48 hours saying, ‘Well, I’m going to be tested today and then if I’m negative, I’m going to go ahead and do what I do.’ And in fact, they won’t even show up positive for at least three up to five days after the exposure.”..
White House chief of staff Mark Meadows told reporters that positive test results for senior aide Hicks came to light “right as the Marine One [helicopter] was taking off” Thursday to take the president to Joint Base Andrews for the flight to New Jersey.
“We actually pulled some of the people that had been traveling and in close contact,” Meadows told reporters Friday at the White House, explaining contact tracing had just begun. Other senior staff, including Dan Scavino and Jared Kushner, have since tested negative, he said.
Public health officials in Somerset County, N.J., are asking Trump’s country club, the Trump National Golf Course, for a list of facility staff, event participants and other people who may have come in contact with the president and first lady, according to a statement from the county’s Department of Health.
“As the public health department for Bedminster, and in conjunction with the New Jersey Department of Health, Somerset County has begun the contact tracing investigation to determine the potential risk of exposure to attendees and staff at the facility to COVID-19,” the statement said.
New Jersey Gov. Phil Murphy, a Democrat, said the golf club, White House and Republican National Committee are all cooperating with state and local health officials, according to NPR member station WNYC.
“The process for gathering information for case investigation and contact tracing has begun, and as far as we know folks are cooperating and we need them to,” Murphy said at news conference Friday.
Amid reports that some people who attended the fundraiser are calling doctors’ offices and health departments in a panic, Murphy urged everyone who was there to take precautions.
“Self-quarantine everybody. Take yourself off the field,” Murphy said. “Wait five to seven days probably and get tested. Even if you test negative, you really have to stay off the field for the full 14 days.” (G)
The White House itself may have become a nexus of infection in the Washington, D.C., area and beyond, hosting events like last Saturday’s celebration of Supreme Court nominee Amy Coney Barrett. At many Trump events, masks were a rarity, social distancing minimal. Video of the Barrett event, for instance, shows people shaking hands, hugging and standing close together.
“They’re way behind the curve in trying to catch all the folks that the president has been around,” said Georges Benjamin, executive director of the American Public Health Association. “The fact that he’s been around so many people and that he doesn’t wear a mask, he could be a superspreader, we just don’t know yet.”
Trump on Friday evening was taken to Walter Reed National Military Medical Center, where he will spend the “next few days,” the White House said.
The White House is complying with CDC guidelines and has started contact tracing, with notifications and recommendations for people who may have had exposure to an infected person, spokesperson Judd Deere said.
The Secret Service, while staying mum on how many of its employees have tested positive for Covid-19 or are quarantining, said it’s following CDC protocols on testing and tracing. Anyone who tests positive is immediately isolated, a spokesperson said.” (H)
“To really be out of the out of the woods, we want to continue seeing” negative results for 14 days after exposure to the virus, said Michael Mina, a Harvard University physician and epidemiologist. He said the vast majority of individuals will have a positive test results within five to seven days.
It may be impossible to determine exactly how many people Hicks and Trump exposed before they received their positive test results this week. It’s not even clear right now if Hicks infected Trump – or vice versa. It’s also possible they were infected by a third person.
Welty said it may have been “inevitable” that Trump and others in his inner circle became infected “because they were relying solely on testing to keep them safe” and shunning other tools – such as masks and distancing – that can prevent infection.
“It’s too late once you test positive,” she said. By that time, “you’ve already been around too many people and spread it to too many people.”” (I)
“On Thursday (Oct. 1), the two states each launched their own contact tracing apps called “COVID Alert NY” and “COVID Alert NJ,” respectively. These apps, which keep users’ identities anonymous, are based on a new technology developed by Google and Apple. They use bluetooth to connect to nearby phones and alert users if they’ve been in close contact with someone who has been infected with the coronavirus.
From the very start of the pandemic, contact tracing has been an important part of helping to stop the spread of the virus. Contact tracing involves identifying people with COVID-19, figuring out who they came in close contact with, and notifying all of those people so that they can self-quarantine or get tested before spreading the virus to others. Most of those efforts have been conducted by people conducting phone calls.
“We have about 15,000 people statewide who do contact tracing. They call them disease detectives,” New York Gov. Andrew Cuomo said in a briefing on Thursday. “But we’ve been looking for a technology-based solution.”
The contact tracing app “knows where your cellphone is, the app will know where a person who tested positive was through their cellphone and the app can tell you if you were within 6 feet of that person,” Cuomo said. “It doesn’t give names, it doesn’t give any privacy information [and] it’s voluntary.”
This is how it works: When you’ve spent more than 10 minutes within 6 feet of another person with the app, which is “long enough and close enough for you to catch the virus,” your phone exchanges a “secure” and “random” code with the other person’s phone, according to the COVID Alert NY app. The phones will store these random codes in a list.
If you end up testing positive for COVID-19, a public health representative will call and ask if you’d be willing to share the app’s list of random codes to help protect other people. “Sharing your list is secure and private,” according to the app descriptions. “The app never reveals who you are to anyone.” Also, the app will constantly compare its own list to the list of infected codes, and if there’s a match it will send a notification to the person’s phone, alerting you that you may have been in close contact with an infected person. You also have the option to keep track of your own symptoms on the apps.” (J)
“With the president and first lady’s stunning diagnoses of COVID-19, the couple will receive exemplary care. They will have all the support they need to—we hope—emerge fully recovered from this potentially lethal virus.
That’s as it should be. But the tens of millions of Americans who could receive similar diagnoses will continue to be sent into spirals of uncertainty—and, for a tragically large number, death itself. Too many of those who fall ill will not have the means or wherewithal to follow even the most basic Centers for Disease Control and Prevention guidelines for those who have been exposed.
The news that the coronavirus has infected one of the most powerful people on the planet should serve as a sobering reminder that this pandemic knows no politics and respects no borders. It’s a reminder, too, that the U.S. government, at the federal, state and local level, needs to provide support through the duration of this pandemic so that every American has what’s needed in the event that they, too, are struck by this virus…
During this pandemic, our societal and structural failures have been laid out for the world to see. At least 28 million Americans don’t have health insurance, and millions of others are underinsured. Too many parents, often those in low-wage jobs, don’t have paid sick leave. About 60 percent of the workforce is paid hourly, and the strains on these workers during the waves of closures and economic shutdowns have proved devastating…
The first family’s diagnosis is just the latest indication that we are nowhere near the end of this pandemic. More than nine of every 10 people in this country have yet to be infected by the coronavirus. With more than 200,000 deaths already and a projection of 371,000 deaths by the year’s end, we need to continue to embrace the guidance laid out by public health experts that we know works: again, we must wear masks, practice social distancing, test and trace, and make prudent decisions for individuals and for their communities…
The president and first lady’s diagnoses should serve as a wake-up call to us all. COVID-19 will thrive if we are divided and dismissive of its dangers. And it can only be bowed if we follow the public health road map to a better day.” (K)
“Less than 10 percent of Americans have antibodies to the new coronavirus, suggesting that the nation is even further from herd immunity than had been previously estimated, according to a study published Friday in The Lancet.
The study looked at blood samples from 28,500 patients on dialysis in 46 states, the first such nationwide analysis.
The results roughly matched those of an analysis to be released next week by the Centers for Disease Control and Prevention, which found that about 10 percent of blood samples from sites across the country contained antibodies to the virus.
Dr. Robert R. Redfield, the director of the C.D.C., was referring to that analysis when he told a congressional committee this week that 90 percent of all Americans were still vulnerable to the virus, a C.D.C. spokeswoman said.” (B)
“Covid-19 infections were trending upward again Monday in the United States as thousands of students returned to New York City classrooms and public health experts warned that a “twindemic” could be on the horizon as we head into flu season.
Two days after the U.S. recorded its 200,000 Covid-19 fatality, the number of confirmed cases in the country was closing in on 7 million and accelerating, according to the latest NBC News figures.
The seven-day average of new coronavirus cases in the U.S. dipped below 40,000-per-day for the first time since June on Sept. 11, the day America marked the 19th anniversary of the Al Qaeda terrorist attacks.
By Friday it was back over 40,000 again, according to an NBC News tally.
That’s still far less than the record 70,000-plus infections that were being logged in June. But the upcoming flu season could derail progress made in bringing down the coronavirus infection rate, experts warned.
“As the United States and the rest of the globe tries to gain its footing with a pandemic that has already killed nearly a million people and sickened almost 30 million, it faces another virus this fall that could devastate our progress thus far: the season flu,” Johns Hopkins University warned in a press release in advance of a conference of public health experts Tuesday that will address the issue. “That is, unless we take action now to minimize cases with effective, widespread vaccination.”
Before the pandemic, only about half the U.S. population heeded the advice of most doctors and got a flu vaccine during the 2018-19 season, according to the federal Centers for Disease Control and Prevention.
While President Donald Trump appears determined to unveil a Covid-19 vaccine before Election Day —even if experts and FDA officials might object — “the cold reality is that we should plan for a winter in which vaccination is not part of our lives,” The Atlantic reported.
“We must, over the next few weeks, get that baseline of infections down to 10,000 per day, or even much less if we want to maintain control of this outbreak,” Dr. Anthony Fauci, the nation’s leading expert on infectious diseases, said in an email to the magazine.” (C)
“As COVID-19 cases tick up in Massachusetts, no one is eyeing the numbers more keenly than the hospital leaders who will have to respond to a second surge.
Hospitals officials are watching the case counts daily, with memories still fresh of legions of sick people filling wards in the spring. The number of people hospitalized with COVID-19 around the state remains low, but has been inching up in certain places in the past couple of weeks. So, too, has the rate of positive COVID-19 tests reported statewide. And any increase in cases in the community will eventually reach the hospital doors.
“We are very concerned about the rising [infection] rates that we have seen,” said Dr. Paul Biddinger, director for emergency preparedness at Mass General Brigham, the hospital group formerly known at Partners HealthCare.
Hospitals in Springfield and Boston reported slight upticks in COVID-19 patients, but Mass General Brigham, the largest hospital group, had only 49 cases on Tuesday and has not seen an increase in recent weeks. Statewide, COVID-19 hospitalizations have held relatively steady since July 24, with 396 reported on Wednesday, compared with nearly 4,000 on May 1.
A total of 338 new confirmed cases were reported Wednesday and two deaths.
The percentage of positive COVID-19 tests in Massachusetts rose to 2.2 percent, up from the mid-July low of 1.7 percent, according to Wednesday’s report from the state Department of Public Health.
Usually hospitalizations start to spike about two weeks after positive tests results go up, and intensive care unit admissions increase two weeks after that.
“The key is to recognize changes so that we can act quickly,” Biddinger said.
In the spring, hospitals cobbled together the space and staff to care for hundreds of severely ill patients — in many cases more than ever before seen — and the lessons on how to do that will guide the response to whatever the fall brings. Advances in understanding how to treat the illness might lead to shorter lengths of stay or fewer admissions. And improved testing capacity means hospitals are no longer in the dark about how many patients might show up at their doorstep….
“If you look historically at pandemics, there is almost always a second surge,” Biddinger said. He has no idea when that second surge might occur, but sees two factors that could bring it on: a “loss of vigilance” against the virus as people tire of staying apart and wearing masks, and the tendency to gather inside as temperatures cool…
And two critical problems linger from the spring: inadequate testing and the continuing struggle to obtain enough personal protective equipment or PPE — the gowns, face shields, masks, and gloves that staffers need to avoid infection.
Testing is essential to determine when hospital employees can return to work, and whether patients need to be isolated and cared for only by people in full PPE.
Baystate Health does not “have the capability to do point-of-care, rapid-turnaround testing,” said Artenstein, who called for a coordinated federal response. “We have not yet received the equipment or reagents to do that kind of testing. Without that, we don’t have the ability to make decisions quickly.”” (D)
“As the school year starts up again and sunset gets earlier and earlier, local hospitals are quietly preparing for the possibility of another crisis that could transpire this fall and winter.
It’s referred to is as a “twindemic,” a simultaneous flareup of the coronavirus and the flu, two deadly viruses that have a similar range of symptoms.
Though local hospital executives are hopeful that a twindemic won’t actually befall New Jersey, they’re readying for the possibility that it does and instituting measures in an effort to prevent it.
Those measures include readying tests that would screen for both COVID-19 and influenza with a single swab and rolling out flu vaccinations and encouraging the most vulnerable members of the population to get shots this year…
First-hand experience with coronavirus patients in the spring has made local hospitals more confident about how to respond if a second wave occurs, the doctors said. And now, preparing for a potential onslaught of patients is more of a familiar routine — stocking up on personal protective equipment, readying staff and continuing to check their temperatures daily.” (E)
“Forty percent of healthcare workers with COVID-19 were not showing symptoms when they were diagnosed, according to a new meta-analysis published in the American Journal of Epidemiology.
Researchers examined 97 studies published in 2020, including 230,398 healthcare workers across 24 countries.
The analysis found the estimated prevalence of infection was 11 percent among healthcare workers using polymerase chain reaction testing, and 7 percent of healthcare workers were positive by antibody tests.
Nearly half (48 percent) of healthcare workers testing positive for COVID-19 were nurses, and 25 percent were physicians, according to the analysis. Twenty-three percent were other healthcare workers.
Forty-three percent of COVID-19 positive medical personnel were working in hospitalization/non-emergency wards during the screening, the analysis found. Twenty-four percent of them were working in the operating room, 16 percent were working in the emergency room and 9 percent were working in the intensive care unit. Twenty-nine percent reported “other” locations…
Dr. Muka said: “Healthcare workers suffer a significant burden from COVID-19. A significant proportion of healthcare workers are positive for COVID-19 while asymptomatic, which might lead to the silent transmission of the disease within hospitals and in the community. The symptoms associated with COVID-19 in HCW could be used as an indicator for screening in settings with limited testing capacities.”
Co-author Professor Oscar Franco, MD, PhD, from the Institute of Social and Preventive Medicine, University of Bern, Switzerland, concluded in a news release: “Because we might miss a large proportion of COVID-19 cases if screening targets only symptomatic HCW, universal screening for all exposed HCW regardless of symptoms should be the standard strategy. While more research is needed to understand specific interventions that can help reducing SARS-CoV-2 infection among healthcare personnel, it is clear that providing healthcare workers with adequate personal protective equipment and training is essential.”” (F)
“Roughly nine weeks’ of previously unpublished federal data provided to the Wall Street Journal shows an average of 120 patients a day contracted the new coronavirus inside U.S. hospitals.
The figure comes from data reported by half of U.S. hospitals to the CDC between May 14 and July 14, after which data is unavailable because the government changed its data collection system and dropped the question about new cases of hospital-acquired COVID-19.
In that timeframe, more than 7,400 patients likely caught COVID-19 in hospitals where they sought care for other conditions. The CDC data didn’t track infections among hospital staff.
Ashish Jha, MD, dean of Brown University’s School of Public Health in Providence, R.I., told the WSJ the data shows the need for federal authorities to revive reporting requirements for new cases of hospital-acquired COVID-19. “We need to know this,” he said.” (G)
“Even with relaxed social distancing practices, national and local healthcare experts are still predicting and preparing for a second wave of COVID-19 this fall, according to Health News Hub. Dr. Ajay Kumar, Chief Clinical Officer for Hartford Healthcare said during a media briefing, “Social distancing is the only thing we have to decrease the spread of this disease… (The disease) is still as lethal as it was in February, March and April.”
During the current lull in coronavirus cases in several states across the U.S., healthcare facilities are doing what they can to best prepare themselves for the looming second wave. Below are some tools and preparedness strategies hospitals are doing to best fight the spread of COVID-19, as per Health News Hub:
Stocking up on personal protective equipment (PPE) and making sure there is enough on hand to protect staff and patients.
Optimizing contact tracing efforts to identify those who have has contact with somebody who has tested positive for COVID-19.
Maintaining hospital and healthcare facilities so that they are safe for patients who need treatment for the coronavirus, or for patients who need help for other healthcare concerns.
Streamlining communication plans to make sure staff and patients are kept updated on hospital COVID-19 protocols through a mass notification solution.
Maintaining capacity so that teams can easily scale operations up or down to meet the demand for care anticipated in a second wave.
Healthcare facilities are also leveraging the technology tools they have in place to help with hospital operations throughout the pandemic. SMS opt-in has been extremely helpful for patients and visitors entering a healthcare facility. Those who opt-in will receive targeted notifications on a specific topic, COVID-19 for example, and they can easily opt-out of these notifications after leaving the hospital.
Mass notification solutions with polling capabilities have also been extremely useful for sending wellness checks out to internal staff to ensure they are feeling safe and well. Polling has also been used to fill vacant shifts to make sure hospitals and healthcare facilities are not understaffed. This will be crucial in the case of the second wave.” (H)
“France and the UK on Thursday set all-time records for daily coronavirus infections.
Other European countries are seeing their highest cases since the continent’s peak earlier this year.
The EU’s health commissioner said that in “some member states, the situation is now even worse than during the peak in March.”
Much of Europe was devastated during the first wave of the pandemic, which was followed by a marked lull.
Better testing systems and infrastructure could go someway to explaining the new high figures — but experts agree that a resurgence is underway.
France and the UK recorded their highest daily COVID-19 cases since the global outbreak began, and the EU warned that some of its countries now have worse outbreaks than they had in March.
Stella Kyriakides, the EU’s health commissioner, warned on Thursday that in “some member states, the situation is now even worse than during the peak in March.”
Taken together, the developments point to the feared second wave of the pandemic having arrived in Europe.” (I)
“In Munich, normally brimming with boisterous crowds for Oktoberfest this month, the authorities just banned gatherings of more than five people. In Marseille, France, all bars and restaurants will be closed next Monday. And in London, where the government spent weeks urging workers to return to the city’s empty skyscrapers, it is now asking them to work from home.
Summer ended in Europe this week with a heavy thud amid ominous signs that a spike in coronavirus cases may send another wave of patients into hospitals. Officials across the continent fear a repeat of the harrowing scenes from last spring, when the virus swamped intensive care units in countries like Italy and Spain. Already in Spain, some hospitals are struggling with an influx of virus patients.
“I’m sorry to say that, as in Spain and France and many other countries, we’ve reached a perilous turning point,” Prime Minister Boris Johnson said on Tuesday, as he imposed new restrictions — including shutting pubs and restaurants at 10 p.m. — to prevent Britain’s National Health Service from becoming overwhelmed.
But just how imminent is the peril?
As they weigh actions to curb a second wave of the virus, Mr. Johnson and other European leaders are dealing with a confusing, fast-changing situation, with conflicting evidence on how quickly new cases are translating into hospital admissions — and how severe those cases will end up being…
Other experts, however, warn against being lulled into complacency: the gap between case numbers and hospital admissions, they say, is mainly a reflection of the fact that more people are being tested, and more quickly.
“Deaths and hospitalizations are a lagging indicator,” said Devi Sridhar, director of the global health governance program at the University of Edinburgh. “There was no lag back in March because we only tested people who were already in the hospital. At a certain point, your I.C.U.’s are going to fill up.”
The uncertainty about hospitalizations and deaths is another example of how mysterious the virus remains, even after 10 months of intense study. And that uncertainty complicates the task for political leaders who are balancing the need to protect their citizens with a desire to avoid imposing more lockdowns.
In France, where the government has adopted a philosophy of learning to live with the virus, President Emmanuel Macron has bucked pressure to impose new national restrictions and left it to cities to impose tighter curbs on public gatherings.
France currently has more than 5,700 people hospitalized with Covid-19. Roughly 900 of them are in intensive care. That is more than during the summer, when hospitalizations dropped to about 4,500 people, but it is far less than during the peak last April, when more than 32,000 were hospitalized…
There are worrying signs: Hospitals in Paris will postpone 20 percent of surgeries, starting this weekend, because of the increase in virus patients, who now account for 20 percent of all patients in intensive care.” (J)
“UK Prime Minister Boris Johnson on Friday told reporters that the UK is “now seeing a second wave coming in” and that it was “inevitable.”
“Obviously we’re looking very carefully at the spread of the pandemic as it evolves over the last few days,” Johnson said. “There’s no question, as I’ve said for weeks now, that we could (and) are now seeing a second wave coming in. We are seeing it in France, in Spain, across Europe. It has been absolutely inevitable we will see it in this country.
“I don’t want to go into second national lockdown. The only way we can do that is if people follow the guidance.”
British Health Minister Matt Hancock said Sunday that the country was “at a tipping point” following a new rise in cases on Saturday, when Britain registered 4,422 new cases, the highest number since early May.
“People must follow the rules and if they don’t, we will bring in this much more stringent measures,” Matt Hancock said in a BBC interview. When asked about re-imposing a second national lockdown, the minister said: “I don’t rule it out. I don’t want to see it.”…
The UK announced Sunday that anyone who tests positive for coronavirus or has been traced as a close contact will be required by law to self-isolate from September 28 or face fines from £1,000 ($1,300) to £10,000 ($13,000) for repeat offenders. Those with lower incomes will be supported by a £500 ($650) payment, according to a government statement….
New restrictions were also announced on Friday in Madrid, which accounts for approximately a third of all new cases in Spain, according to the Spanish Health Ministry. The country reported a record 12,183 daily cases on September 11, and has the highest number of cases in Europe at more than 600,000, with more than 30,000 deaths….
WHO Europe director Hans Kluge warned this week of “alarming rates of transmission” and a “very serious situation” in the region, adding that weekly cases have exceeded those reported during the March peak.” (K)
“Prime Minister Justin Trudeau is warning Canadians that the second wave has arrived in many parts of the country.
“We’re on the brink of a fall that could be much worse than the spring,” Trudeau said Wednesday during a 12-minute takeover of suppertime television. “It’s all too likely we won’t be gathering for Thanksgiving [Oct. 12], but we still have a shot at Christmas.”
During the height of the pandemic last spring, Trudeau took questions from reporters almost every day for weeks — briefings that networks covered voluntarily. On Wednesday evening, he took the rare step, for a Canadian prime minister, of requesting airtime on major TV networks.
For Canada’s four largest provinces, Trudeau said the second wave of Covid-19 is underway.
With kids at home and classes online, students are extra reliant on technology. But that’s not an easy lift in lower-income districts that lack funding and resources.
The increasingly grim backdrop: Trudeau’s warning comes as Canadian Covid-19 cases climb higher, a setback that follows the country’s success in flattening the curve earlier in the pandemic.
Trudeau noted that back on March 13 when the country went into lockdown there were 47 new cases of the virus. “Yesterday alone, we had well over 1,000,” said Trudeau, who appeared on TV screens in a dark suit and tie, standing in front of four Canadian flags and a desk.
Canada’s top doctor warned this week that the only way to prevent the acceleration of the spread is if everyone works to put on the brakes.
“My message today is the time is now,” Chief Public Health Officer Theresa Tam said. “Our actions right now are what matters for keeping epidemic growth under control.”
On Wednesday, officials said Canada saw an average of 1,123 cases reported daily during the past seven days, compared to just 380 cases reported per day in mid-August.” (L)
“Florida Gov. Ron DeSantis says he is lifting all restrictions on businesses statewide that were imposed to control the spread of the virus that causes COVID-19. Most significantly, that means restaurants and bars in the state can now operate at full capacity.
Up to now, restaurants and bars in Florida could serve customers indoors at 50% of legal occupancy. DeSantis said his new executive order lifts that restriction statewide, though local governments can keep additional limits in place if they’re justified for health or economic reasons.
“Every business has the right to operate,” DeSantis said. “Some of the locals can do reasonable regulations. But you can’t just say no.”
DeSantis also said his order would stop cities and counties from fining people for not wearing mandated face coverings. He said fines and other penalties imposed so far would be suspended.
Currently, Miami-Dade, Broward and other counties in South Florida have locally imposed limits on the hours restaurants and bars can operate and how many customers they can serve indoors.
Broward County Mayor Dale Holness told NPR member station WLRN on Friday, “We’re hoping that the governor will allow us to have deeper restrictions than the rest of the state. We have a greater spread of the virus in South Florida than other parts of the state.”
Miami-Dade officials said they were still assessing what the order means for the county. Mayor Carlos Giménez told The Miami Herald that he believed the county would still be able to enforce its face covering mandate but “will have to speak to our attorneys about [our] ability to enforce individual fines.”
The number of coronavirus cases in Florida has dropped steadily since the peak in mid-July. Since then, DeSantis said, “we’ve actually seen more economic activity, more interaction. Schools have opened, all the theme parks are open, more people have visited.”
Hospitalizations for COVID-19 statewide are down 76% from the peak, the governor said.
DeSantis said he’s seen no signs of a possible “second wave” of infections but said that hospitals have plenty of capacity and the state is ready to respond if one emerges.
There are no restrictions on the number of people who can attend outdoor sporting events in Florida, according to the governor, who added the state hopes to host what he called “a full Super Bowl” in Tampa in February.” (N)
“Florida added 2,795 coronavirus cases Saturday, bringing the total number of infections statewide to 698,682 cases.
The state also announced 107 coronavirus deaths. Since the first coronavirus case was found in Florida, 14,190 people have died from the virus. Among the deaths was a 12-year-old girl in Duval County, the ninth death of a child because of coronavirus in Florida.
The weekly death average increased to about 106 people announced dead per day. The peak death average came in early August, when about 185 deaths were announced per day.
Cases that resulted in a hospitalization increased by 171 admissions.
Hospitalizations: About 2,100 people across Florida are hospitalized with a primary diagnosis of coronavirus, according to the Agency for Health Care Administration. About 420 are in the Tampa Bay area.
Statewide, about 24 percent of hospital beds are open and 22 percent of ICU beds are open. In Tampa Bay, about 20 percent of hospital beds and 14 percent of ICU beds are available.
The largest area hospital, Tampa General Hospital, had no ICU beds available as of Saturday morning.” (O)
“When Dr. Shereef Elnahal walked through his New Jersey hospital in April, he couldn’t believe what he was seeing.
There were 300 patients being treated for Covid-19, filling hospital rooms and spilling out into the halls of the emergency room. The trauma center, once used for gunshot wounds and car crash victims, was now filled with people on ventilators.
“It was really like nothing we’ve ever seen before,” said Elnahal, president and CEO of University Hospital in Newark.
“I have memories of walking around and I would look inside the rooms where that was possible. Almost every person was a person of color,” he told NBC News.
Elnahal’s hospital is one of the more than 100 major medical centers that treat America’s most vulnerable patients: communities of color who have been disproportionately harmed by Covid-19. Data has increasingly shown that Black and Hispanic patients are more likely to be hospitalized with the virus and, in many cases, more likely to die from it.
“We’re learning more and more that it’s these vulnerable communities being hit harder by the pandemic,” said Beth Feldpush, senior vice president of policy and advocacy for America’s Essential Hospitals, a group representing the more than 300 hospitals that treat uninsured patients. “Our hospitals are absolutely serving those hardest-hit communities.”
A second surge of Covid-19 this fall and winter could be catastrophic for the U.S., and it’s not just more sick people that doctors worry about. The very hospitals that treat lower-income patients could be forced to shut down or cut crucial services.
“We would absolutely be at risk of closing,” Elnahal said. “It would be a public health disaster for this community.”
The pandemic hit all U.S. hospitals with a financial “triple whammy,” said Aaron Wesolowski, the American Hospital Association’s vice president for policy research, analytics and strategy. Costs increased dramatically, while revenues plummeted.
The hospitals were forced to cover the exorbitant costs of buying extra personal protective equipment like N95 masks, as well as convert wards to treat Covid-19 patients and more uninsured patients. At the same time, they had to stop performing revenue-generating procedures like elective surgeries.
By the end of 2020, hospitals across the U.S. will lose about $300 billion, according to the American Hospital Association. But for major medical centers like University Hospital in Newark, the financial hit of a second wave of Covid-19 would be especially devastating.
“Where there are already cracks in the system, those cracks become earthquakes,” said Dr. Chris Pernell, University Hospital’s chief of strategic integration and health equity officer.
That’s because these safety net hospitals are nonprofit and promise care for all patients, regardless of insurance coverage. Even before the pandemic, they operated on shaky budgets. Jackson Health System in Miami, for example, only has enough cash on hand to operate for 50 days. Private hospitals typically have more than triple that amount of cash in reserve…
In the meantime, hospitals are preparing for the second wave, stocking up on PPE despite lingering shortages and implementing lessons learned from the first surges, especially when it comes to treatment.” (P)
“The pandemic has shown us the importance of vigilant EM planning. When viruses of the past have run their course, EM plans often go back on the shelf and aren’t revisited until the next crisis. This is not to say that organizations always need to have incident command readiness. However, aspects of an emergency command structure and communication should be a constant part of daily workflow and the risk of an outbreak should be a consideration in everyday meetings and reports. For example, assuring that incident command roles are assigned daily and distributing a daily briefing, such as an email, will go a long way in promoting readiness. Ultimately, all organizations should move ahead conservatively – watch the data and evaluate what new trends mean, plan out next steps as new information unfolds, and be flexible to scale up or down accordingly…
“The next surge – whether COVID-19 or something new – will come. Flexibility may be the key to future surge response. While options and plans need to be tailored to each institution or site, here are some ideas to consider based on lessons learned:
• Assure a flexible, but robust, communication structure for use during surge events. This structure should be easily embedded in the incident command response once a decision is made to activate a command center, but flexible enough to assure daily use when the command center is closed.
• Develop options to enable a quicker expansion or conversion to support defined patient care spaces and the required staffing. These alternative care areas may include converting or repurposing existing space into temporary critical care areas or using temporary external structures as we have seen during COVID-19. Alternative staffing models also need to be agreed upon to support these possible new care areas.
• Develop plans for rapidly updating staff, including education on new care guidelines and new care area assignments as well as new communication models to ensure staff is aware of PPE guidelines, technology updates and other changes.
• Create room flexibility using carts or rail systems. This can allow for rapid repurposing of rooms to accommodate specific needs.
• Create plans for “clean” and “infectious” corridors to minimize comingling of likely infectious and likely non-infectious patients.” (Q)
“With a growing tally of more than 7 million COVID-19 cases and over 200,000 deaths from the virus in the United States, the country’s top infectious disease expert is warning that the nation needs to prepare as fall and winter loom.
“Given the fact that we have never got down to a good baseline, we are still in the first wave,” Dr. Anthony Fauci told CNN.
During the 1918 pandemic, the number of cases plummeted before exploding during the colder months later in the year.
“Rather than say, ‘A second wave,’ why don’t we say, ‘Are we prepared for the challenge of the fall and the winter?’” Fauci said.
Among other preventative measures, Fauci says Americans need to wear face coverings, wash their hands and avoid crowds to avoid “surges” in cities and states across the country.
Another precaution that could help first line medical workers dealing with COVID-19 patients is the flu shot. The more people vaccinate this year, the less patients sick with the flu will divert hospital resources away from coronavirus patients…
Fauci warns life may not be ‘normal’ until end of 2021
“We feel cautiously optimistic that we will be able to have a safe and effective vaccine, although there is never a guarantee of that,” Dr. Fauci told a Senate committee this week…
How we got here.
More than 200,000 Americans have died from COVID-19 so far this year, and in many states, infections still are climbing. The U.S. is confirming an average of 41,968 new daily cases, up 13% compared with the average two weeks ago.
Fauci was blunt: More lives could have been saved if everyone in the country better followed recommendations to wear masks, avoid crowds and keep 6 feet apart.
“We know some states did a good job. Some states did not so good a job. Some states tried to do a good job but people didn’t listen,” he said, singling out mask-less crowds in bars. Going forward, “we need uniformity throughout the country.”” (M)
“As Germany cleared away spent fireworks and slept off its hangovers on New Year’s Day, Christian Drosten got a sobering wake-up call: A member of his team—he heads the virology department at Berlin’s Charité hospital—reported that a strange pneumonia was spreading in the Chinese city of Wuhan.
For Drosten, a leading developer of tests for emerging viruses, there was an element of déjà vu. As a doctoral student in Hamburg in 2003, he’d discovered that the outbreak of severe acute respiratory syndrome, or SARS, then terrifying Asia was caused by a coronavirus. Although it was unclear whether a coronavirus was responsible for the Wuhan outbreak, Drosten fully understood the danger. While the viruses are common pathogens known to cause colds, some discovered in recent decades are highly lethal.
He alerted his staff to get ready for the possibility of a deadly pandemic. When Chinese researchers confirmed that the culprit was indeed a coronavirus and on Jan. 10—a Friday—published its genome sequence, the Charité scientists sprang into action. Working through the weekend, they pulled together samples of the SARS virus and other coronaviruses, aiming to make a test that could detect the new threat. Late on Saturday a team member tweeted, “Lab days are happy days! #Wuhan #Coronavirus.”
By Monday they had a test that could confirm whether someone had been infected by the novel coronavirus. Drosten shared the details with the World Health Organization, which published them on its website, and the test was soon deployed around the world. One place that declined to use Drosten’s test was the U.S.; it came up with its own diagnostic tool, which turned out to be flawed and left the country blind for two months as the virus raged. Germany’s test confirmed the country’s first case on Jan. 27. There were 13 more in the coming days, at the time constituting the largest known cluster outside of China. Authorities sequestered Covid-19 patients, tracked down their recent contacts, and slowed infections.”
…..Since developing the test, the 48-year-old scientist…has led a research team at Charité that’s explored how the virus spreads and affects people differently. He’s shared thoughts with colleagues around the world, offered insights at press conferences alongside Germany’s health minister, and advised Chancellor Angela Merkel—a role some have compared to that played by Dr. Anthony Fauci in the U.S.” (R)
“Robert Redfield was overheard by an employee of NBC News on a flight from Atlanta to Washington. According to NBC, Redfield criticized Scott Atlas, a radiologist and Fox News talking head added to the taskforce last month.
“Everything he says is false,” Redfield said about Atlas, NBC reported. Redfield later confirmed he had been talking about Atlas.
Atlas, who has no background in infectious diseases but who appears to have the best current access to Trump of any medical adviser, has been frequently criticized by the scientific and medical communities for offering what public health professionals say is bad advice about coronavirus.
On Monday afternoon, the top US public health expert and infectious diseases lead on the taskforce, Anthony Fauci, chimed in to tell CNN he was concerned that Atlas was at times providing misleading or incorrect information on the pandemic to Trump.
“Well, yeah, I’m concerned that sometimes things are said that are really taken either out of context or are actually incorrect,” Fauci, the head of the National Institute of Allergy and Infectious Diseases, said when asked in an interview if he was worried Atlas was sharing misleading information.” (S)
The United States Postal Service had planned to distribute 650 million face coverings for the Trump administration in April to help curb the spread of the coronavirus, according to newly obtained internal documents reviewed by CNN.
But those plans were scrapped by the White House because it didn’t want to spark “concern or panic” among Americans, senior administration officials told The Washington Post.
“There was concern from some in the White House Domestic Policy Council and the office of the vice president that households receiving masks might create concern or panic,” one administration official told the Post.
The documents obtained by the transparency group American Oversight show the Postal Service was doing this in partnership with the White House Coronavirus Task Force, the Department of Health and Human Services and “a consortium of textile manufacturers.”
USPS was planning to ship the masks in April and was going to prioritize areas “which HHS has identified as experiencing high transmission rates of Covid-19,” according to a draft USPS release. Louisiana’s Orleans and Jefferson parishes were going to be sent masks first, followed by King County, Washington; Wayne County, Michigan; and New York…” (T)
“Top White House officials pressured the Centers for Disease Control and Prevention this summer to play down the risk of sending children back to school, a strikingly political intervention in one of the most sensitive public health debates of the pandemic, according to documents and interviews with current and former government officials.
As part of their behind-the-scenes effort, White House officials also tried to circumvent the C.D.C. in a search for alternate data showing that the pandemic was weakening and posed little danger to children.
The documents and interviews show how the White House spent weeks trying to press public health professionals to fall in line with President Trump’s election-year agenda of pushing to reopen schools and the economy as quickly as possible. The president and his team have remained defiant in their demand for schools to get back to normal, even as coronavirus cases have once again ticked up, in some cases linked to school and college reopenings.
The effort included Dr. Deborah L. Birx, the White House’s coronavirus response coordinator, and officials working for Vice President Mike Pence, who led the task force. It left officials at the C.D.C., long considered the world’s premier public health agency, alarmed at the degree of pressure from the White House.” (U)
“Fauci also discussed Dr. Scott Altas, a White House coronavirus task force member with whom CDC director Robert Redfield has questioned for sharing misleading information with President Trump, according to CNN.
Fauci called Atlas an “outlier,” saying that most members of the task force are working together.
“My difference is with Dr. Atlas, I’m always willing to sit down and talk with him and see if we could resolve those differences,” he said.” (V)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
POST 48. October 1, 2020. “…you can actually control the outbreak if you do the nonpharmaceutical interventions (social distancing and masks). In the United States we haven’t done them. We haven’t adhered to them; we’ve played with them.” (A)
Gov. Phil Murphy, speaking during a Friday news conference, said New Jersey has run into trouble in its efforts to contain the coronavirus because of contact-tracing problems. Murphy made the announcement as he revealed 313 new coronavirus cases and 13 more confirmed deaths were reported (you can watch it here, below).
The update comes as the number of cases rose to 188,817 and 14,112 confirmed deaths have been reported. Read more: NJ Coronavirus, School Reopen Updates: Here’s What You Need To Know
Murphy said more than half of the people contacted through contact tracing have refused to provide information and “this is highly disturbing, to say the least.”
Murphy suggested that the lack of participation in providing information to contact tracers may have slowed efforts to track the virus and ultimately quarantine people to reduce the spread.
The number of people not picking up the call is 19 percent, and the number of people not providing contacts is 52 percent, said Health Commissioner Judith Persichilli.
“It is essential that residents join with the contact tracers in containing this disease,” Persichilli said. “Contact tracers are calling with lifesaving information that will keep you and your loved ones and our communities safe and healthy.”
It also could explain why New Jersey has had a hard time recently in keeping its transmission rate below 1.0, which is considered too high. That means every person with the coronavirus is spreading the disease, on average, to at least one other person.
After weeks of having a rate around 0.82, New Jersey’s rate is currently at 1.04. (A)
“The tracing approach is built on a simple idea: When someone tests positive for the new coronavirus or becomes sick with COVID-19, you find all the people the infected person came into contact with, because they, too, may be infected. Then you help them quarantine for two weeks—almost everyone who becomes sick will show symptoms within 14 days—so they do not accidentally spread the virus any further. The goal is to stop the chain of transmission, says Emily Gurley, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, who has created a free online course to train contact tracers…
Large-scale contact-tracing programs in places such as South Korea and Germany have been instrumental in suppressing the novel coronavirus, SARS-CoV-2. Within days of detecting its first case on January 20, South Korea created an emergency response committee that quickly developed wide-scale virus testing, followed by an extensive scaling up of the nation’s network of contact tracers. Germany similarly committed resources to mobilizing a tracing workforce. In both countries, cases have dropped dramatically.
By contrast, tracing efforts lag in the U.S., where COVID-19 cases hit record highs in mid-July and which leads the world with more than 3.7 million infections and more than 140,000 deaths. The country has no national strategy for contact tracing, says Adriane Casalotti, chief of government and public affairs at the National Association of County and City Health Officials (NACCHO). Instead “the federal government has said to states, ‘do as you wish,’” she adds. According to news reports, this week the White House moved to block $25 billion for tracing and testing in the latest pandemic relief bill being considered by Congress, contending that states already have funding.
Yet many states do not have the money to start large tracing programs. In fact, state public health departments across the U.S. were drastically underfunded even before the pandemic. Since 2008, local health departments have lost close to 25 percent of their employees.
The result is a patchwork of programs with insufficient money and uneven implementation. NACCHO estimates that, given national levels of confirmed cases, the nation needs at least 100,000 contact tracers. And that number would cost local, state, territorial, Native American and federal public health agencies at least $3.7 billion. So far, however, no federal dollars have been specifically allocated to contact tracing “or to any federal contact tracing programs,” Casalotti says…
The next action that comes after a tracer has identified a potential infected person—getting that individual to adhere to quarantine—has proved exceptionally difficult in the U.S. For stopping the spread of a virus, however, isolation is absolutely key. “You can do the contact tracing all you want. But if you’re not also providing these support services people need to isolate, it won’t work,” Madad says. No one is going to quarantine for 14 days if that means losing a job and income or abandoning caregiving.” (B)
“The countries where contact tracing has worked best set up their tracing systems before cases exploded, and as cases grew, they hired more tracers. The U.S. has not done this. In June, when states were in the throes of reopening, only seven states and Washington, D.C., met the Centers for Disease Control and Prevention’s recommendation of 30 contact tracers per 100,000 residents, according to an NPR analysis. According to the latest data from Test and Trace, an organization that grades states on their testing and tracing capabilities, only seven states are currently considered “fully prepared to test and trace.” States meet this threshold if they have a test-positivity rate of 3 percent or less, provide test results in two days or less, and employ five to 15 contact tracers per positive test….
The logistical testing delays are exacerbated by quirks of the American health-care system that are making it even harder for people to get tested and quickly quarantine. Many people can’t get paid leave from work unless they provide proof of a positive COVID-19 test. So if Aunt Sally is feeling sick but her test results haven’t come back yet, she might be required to report to work or forfeit her paycheck for the day. “If that test isn’t showing up for a week, then they’ve already been exposing people for a week,” said another Texas contact tracer, who asked to remain anonymous, because she’s not authorized to speak with the press.
It’s likely that the first time many Americans heard the term contact tracing was this spring. Before that, some public-health departments were little more than two people and an old computer, having lost a quarter of their workforce through aggressive budget cuts since 2009. Because the U.S. has had such an enfeebled public-health system for so long, the public doesn’t trust public-health workers at a time when it’s crucial that they do so. When called by a department they’ve never heard of and asked for a list of all their friends, Americans could be forgiven for thinking, Who the hell are these people?..
These trust issues have become especially pronounced in the Black and Hispanic communities, two populations that have been disproportionately affected by COVID-19. Black and Hispanic people are more than twice as likely as white people to get COVID-19, and are more than four times as likely to be hospitalized with it. Several experts told me that wariness of the government in these communities has been exacerbated by the Trump administration’s public-charge rule, under which immigrants might jeopardize their green card if they accept public benefits. “If the word gets out in a community, ‘Don’t talk to the government, because we are worried the government will do bad things to us,’ then you don’t have trust,” John Auerbach, the president of Trust for America’s Health, a nonprofit that promotes public health, told me…
People have more trust in public-health workers when local health departments, governors, and the president speak with one voice. But some officials have downplayed the virus, some have taken it seriously, and others have ignored it entirely. Other than claiming that the U.S. has gotten “good at” it, Donald Trump hasn’t said much about contact tracing. But perhaps his actions should speak louder than his words: When someone in the White House gets sick, the executive branch traces all of that person’s contacts.” (C)
“Public health is called public health for a reason, says Emily Gurley, an infectious disease expert at the Johns Hopkins School of Public Health: Strategies like contact tracing can only be effective if the community cooperates.
However, there’s no one metric by which to judge a successful contact tracing effort, says Gurley. “You don’t have to be perfect to have an impact,” she said. “And just because cases are still going up doesn’t mean you’re not having an impact, as well.”
If a community tests only a few people, but reaches 100% of respondents, they may be less effective at stopping transmission than a community that identifies all the local cases through testing but only reaches 40% of them by phone. And response rates don’t reflect the efficacy of each interview. Picking up the phone is one thing; giving out a list of close contacts is another.
But contact tracers do need all the responses they can get, and, crucially, as many honest, comprehensive interviews as possible. To safely lift lockdowns, the COVID-Local guide recommends cities ensure they’re reaching 75% of each positive patient’s close contacts within a day of testing…
Like mask-wearing, which became fiercely politicized despite evidence that it significantly reduces transmission of disease, attitudes towards contact tracing have been muddied by misinformation and mixed messaging. …
This resistance varies by region and by state, Waters says, but it tends to line up with political differences. “A large proportion of the population views not participating in contact tracing as aligned with their political tribe,” he said on a panel at the Disease Prevention and Control Summit last month.
But contact tracing pushback isn’t just about politics. Even as coronavirus disproportionately impacts communities of color, trust in the federal government is lowest among Black people, and reports show that some Latinx communities are wary of getting tested for the virus and more fearful of seeking medical help because of fears of immigration enforcement….
Already, one promising contact tracing tool in the U.S. has been stymied by privacy fears. In April, Apple and Google introduced a plan to facilitate contact tracing by allowing people who tested positive to send out an anonymous ping via the Bluetooth connection that most smartphones have, to alert anyone who had come into close contact with their device in the previous few days. Despite privacy and anonymity assurances, surveys showed that people were wary of their location being linked to their health information…
In part because health officials understand this reticence — and in part because of coordination and technical issues — the U.S. has yet to roll out widespread app-based testing, as many other nations in Europe and Asia have, and the Apple and Google API has yet to be adopted at scale. Even officials from Singapore and Iceland, where sophisticated contact tracing apps were part of an early coronavirus response, advocate a hybrid approach. Pairing targeted phone alerts with traditional human “disease detectives” who call on the phone can capture the widest swath of the population, they say.
“It’s not too late for public health authorities to communicate better about this tech, what it entails and why it’s important,” said Kreps…” (D)
“Our local public health authorities haven’t skimped on sharing data tied to the novel coronavirus. Visit the dashboards on the Department of Health and Public Health—Seattle and King County websites and you’re liable to get dizzy from all the curves outlining the changes in cases, hospitalizations, and tests since the start of the pandemic.
But until recently, Washington officials had held out on publicly quantifying one area of our response to Covid-19: contact tracing, or the effort to identify and isolate people who have crossed paths with infectious hosts to curb the virus’s spread. Though we knew the state had struggled, both initially and later on, to reach cases and their close contacts, we couldn’t point to any numbers assessing the current state of our disease containment effort.
Now we know why officials weren’t exactly in a rush to divulge the details. On Wednesday, the DOH released a report that showed the department had fallen well short of its case investigation and contact tracing goals despite mobilizing an army of sleuths. The department had sought to reach 90 percent of cases within one day of a positive test result. During the weeks between August 2 and September 5, the state never topped 51 percent in that area. The DOH had also targeted an 80-percent connection rate with contacts 48 hours post-case confirmation. It hasn’t yet met that mark. “While we expect our outcomes to improve over time, this initial data shows we have work to do,” state secretary of health John Wiesman said in a press release.
Are those goals too lofty? Hard to say. Many states still haven’t published their contact tracing stats, and those that have often use slightly different metrics. Public Health—Seattle and King County’s latest dashboard doesn’t lend itself to an apples-to-apples comparison with the broader state data, either, but it does provide some more interesting bits. For example, 60 Covid-19 contact tracers currently work for the authority. In mid-July, when cases were rising again, the number was half that.
Since the local headcount bump, the county’s case interview performance has stabilized. Roughly 60 percent of positive cases get interviewed (not just reached) on the same day they’re assigned to a contact tracer. Still, thanks to the pre-symptomatic period and lags between symptom onset and testing, nearly nine days of viral shedding have typically passed by the time tracers speak with infected individuals. Not ideal.” (E)
“New York Gov. Andrew Cuomo (D) was joined remotely by former New York City Mayor Michael Bloomberg on Thursday as Cuomo described efforts to develop and implement a comprehensive coronavirus contact tracing program in the Empire State.
Such a program, Cuomo said in his daily briefing, will “require, under any estimate, a tracing army to come up to scale very quickly,” which he said will be a vital part of any state efforts to reopen businesses and institutions.
Bloomberg, joining the briefing through a video link, described a contact tracing system as “one of the most important steps we need to take,” adding “when social distancing is relaxed, contact tracing is our best hope for isolating the virus when it appears and keeping it isolated.”
Bloomberg said his philanthropic foundation will develop the system in partnership with Johns Hopkins University, “the best public health school in the world,” as well as the organizations Vital Strategies and Resolve to Save Lives.
The former mayor said the City University of New York and State University of New York will help identify potential applicants for contact tracing jobs and that Johns Hopkins has developed an online training class that will conclude with a mandatory test.
“We’re not going to put up people there that don’t know what they’re doing,” he added.
Bloomberg also noted that the program will help develop a broader “playbook” for contact tracing through its efforts, saying “we will release that playbook publicly so cities and states around the country can use it and scan nations around the world. That way the work we do here in New York really can help fight the virus globally.”
Cuomo expressed a similar sentiment, saying of the state: “In many cases we’ve dealt with challenges first; we figure it out and then we work with other places to actually learn from what we’ve done.”
“I think this is going to be one of those examples,” he added. “It will also be a laboratory to put together the best system ever put together so we can share that with other governments, and that’s what Mayor Bloomberg does so well.”” (F)
“New York City’s ambitious contact-tracing program, a crucial initiative in the effort to curb the coronavirus, has gotten off to a worrisome start just as the city’s reopening enters a new phase on Monday, with outdoor dining, in-store shopping and office work resuming.
The city has hired 3,000 disease detectives and case monitors, who are supposed to identify anyone who has come into contact with the hundreds of people who are still testing positive for the virus in the city every day. But the first statistics from the program, which began on June 1, indicate that tracers are often unable to locate infected people or gather information from them.
Only 35 percent of the 5,347 city residents who tested positive or were presumed positive for the coronavirus in the program’s first two weeks gave information about close contacts to tracers, the city said in releasing the first statistics. The number ticked up slightly, to 42 percent, during the third week, Avery Cohen, a spokeswoman to Mayor Bill de Blasio, said on Sunday.
Contact tracing is one of the few tools that public health officials have to fight Covid-19 in lieu of a vaccine, along with widespread testing and isolation of those exposed to the coronavirus. The early results of New York’s program raise fresh concerns about the difficulties in preventing a surge of new cases as states across the country reopen.
The city has successfully done contact tracing before, with diseases like tuberculosis and measles. But as with much involving the coronavirus outbreak, officials have never faced the challenge at this scale, with so many cases across the five boroughs.
The city’s program has so far been limited by a low response rate, scant use of technology, privacy concerns and a far less sweeping mandate than that in some other countries, where apartment buildings, stores, restaurants and other private businesses are often required to collect visitors’ personal information, which makes tracking the spread easier…
“For each person, you should be in touch with 75 percent of their contacts within a day,” he said.
He suggested that the poor showing stemmed in part from the inexperience of the contact tracers and insufficient hands-on training.
“This is a skill,” he said. “You need to practice.”…
Dr. Halkitis at Rutgers said he thought the low cooperation rate was likely due to several factors, including the inexperience of the tracers; widespread reluctance among Americans to share personal information with the government; and Mayor de Blasio’s decision to shift the program away from the city’s Department of Health.” (G)
“HONOLULU (KHON2) — The head of the state’s contact tracing program, who took over just before a Department of Health leadership shakeup, has already made big inroads in overhauling the system. Dr. Emily Roberson spoke for the first time with Always Investigating. Under Roberson’s new system, the health department is now collecting key data that shows what kind of settings and activities are spreading COVID, and where and how it is being safely blocked…
“They are reaching out as soon as people test positive,” Roberson said, “to make sure they have the information they need in terms of education and to make sure we’re able to screen for any specialized follow-ups that may be needed.”
“First contact callers” are dialing up every positive person with 24 hours and screening for whether specialized follow-ups are needed.
“We have about 50% of the people we attempt to reach within 24 hours, either they have a bad number, they have no number or we are just not able to get them on the phone,” she said.
Of those they can reach, the callers sort the cases among eight specialized investigation teams led by a disease investigator and supported by the National Guard and a cadre of contact tracers.
Additional targeted support such as nurses, community workers, monitors and even translators can jump in when needed…
Roberson’s other overhaul efforts include changing the forms, scripts and procedures to rapidly collect more detailed data…
Now, Roberson tells Always Investigating that her team has collected weeks of data that gets down to business.
“It does include questions about gyms, personal care services, congregate settings, schools, correctional facilities and a whole bunch of information about that, restaurants for example, bars,” she explained.
“There are a lot of times where we might have clusters that involve a specific type of employee or a specific workplace, but when we really investigate them further we find out that the transmission is taking place outside of that location,” Roberson said, adding that social after-work parties, lunch-break hangouts, smoke breaks, or roommates who happen to work together becoming infected at home appear to be the actual source of spread.
“It could be there’s transmission happening technically around the work building but it’s not so much associated with the work itself, it’s more when you’re on your break, or you’re hanging out with your friends,” Roberson said. “Even though there were this many cases at this workplace, it seems everyone got it when they went to this party. It’s not a case where they put their customers or, in health-care their patients, at risk as much as people relax when they are with their friends and it’s spreading socially.”
That is consistent with what small businesses and organizations have been saying about their own contact tracing, finding off-work social spread, not on-the-job, in-store or in-restaurant where masks, barriers, distancing and sanitation regimes are followed to the tee.
“As a business, we’re already doing that, so we know it’s not coming from us,” Tina Yamaki, President of the Retail Merchants of Hawaii, said at the House economic hearing. “If a majority of the numbers are coming from funeral homes or private parties or care homes, we need to take that into consideration, too, instead of a full shutdown.”” (H)
“Washington state will join California and Oregon in soon launching a voluntary contact tracing application that Google and Apple jointly developed that alerts users if they have been exposed to the coronvirus.
The app will be voluntary and anonymously notify a user if they have been exposed to someone who tests positive, Gov. Jay Inslee said Thursday.
“You volunteer to share your information, if you desire, with the app, and you’re voluntarily notified should you desire that,” Inslee said. “And all of this is maintained with great privacy protections. We’ve insisted on that.”
Washington Department of Health officials have had mixed results when it comes to their contact tracing efforts, and while they have the adequate staffing to make calls in 16 counties that require their help, State Secretary of Health John Wiesman told reporters Wednesday, that their challenges are not unique.
“Other states have been experiencing the same kinds of issues with folks not returning calls or difficulty getting the phone numbers,” he said.
Ideally, contact tracing and case investigations are done at a local level, Wiesman said, and the majority of local health jurisdictions in the state are doing their own case investigations and contact tracing, or bringing on contractors to help. Last week, in Spokane County, 76% of COVID-19 cases were epidemiologically-linked, connected to one another through contact tracing or investigators identifying spread in a similar location.
A report from DOH shows that their case investigators made contact with about 65% of people with confirmed cases of COVID-19 for an interview.
Wiesman said the Apple-Google application product is forthcoming, and the department is working with the companies to identify some “pilot opportunities.”” (I)
“But state leaders remain guarded in their enthusiasm, recognizing some Oregonians may be unlikely to participate over privacy concerns and acknowledging equity challenges over who may access the technology. An unrelated symptom-monitoring project touted as a “game changer” by Gov. Kate Brown got shelved last month for failing to ensure enough participation among people of color.
“Knowledge is power when it comes to stopping the spread of COVID-19, and this pilot project will help people make informed decisions to keep themselves healthy, while still protecting individual privacy,” Brown said in a statement this week announcing the new technology effort.
“Oregon officials would not say where the technology will be available under the pilot, noting details are still being finalized. But the Oregon Health Authority is in talks with a university or universities about promoting the system for students, suggesting it could be available in Eugene at the University of Oregon, Corvallis for Oregon State University or in Portland at Portland State University.
The digital contact tracing system will be voluntary and completely anonymous, said Dr. Timothy Menza, a senior health adviser for the Oregon Health Authority.
It works by using Bluetooth signals from cell phones to record anonymized identifiers for cell phones that are in close proximity. The technology is able to determine roughly how close and how long the phones are near one another, with the federal government considering close contact as within six feet for at least 15 minutes.
That anonymized data would stay on an individual’s phone unless the person later tests positive for COVID-19, Menza said. At that point, the infected person would receive a personal identification number from the state or county health department after the COVID-19 diagnosis had been confirmed.
The person could then voluntarily enter the PIN into their cell phone, which would begin the process of uploading the anonymized Bluetooth data to a national server, Menza said. Other participants’ phones would regularly scan the national database to see if they’ve been in close contact with a confirmed coronavirus case – and if there’s a match the person would receive a notice on the phone about exposure and suggesting testing.
State and local health departments would not receive notice about exposures, Menza said. But people who are infected, or people who seek testing after receiving a notice, could voluntarily disclose that they are using the technology.
So-called proximity tracing applications do not take the place of traditional contact tracing by public health officials that involves detailed case investigations to determine the names of people who might have been exposed to a person with a confirmed infection.
But the technology does allow for more thorough tracing efforts, allowing notification among people whose identities might not be known to an infected person – such as someone who rode the same bus, ate at the same restaurant or attended the same party.
Proximity technology is controversial, particularly among some Americans who are unwilling to share personal data for privacy reasons and skeptical of the big tech companies offering the service. But it’s been embraced in some places, including Scotland, where a new app was reportedly downloaded 600,000 times.
Menza said proximity tracing apps have the potential to make a big difference if widely adopted. He pointed to research by the University of Oxford, which estimates that cases and hospitalizations could decline if just 15 percent of the population uses the technology.
Modeled for the state of Washington, that adoption level suggested a 15 percent decline in infections and 11 percent reduction in deaths.
“In that sense,” Menza said, “it seems pretty powerful.”
But that would require participation of more than 600,000 Oregonians, essentially the entire population of Portland.
“We’ll have to put in the work to make that happen,” Menza said.” (J)
PART 1. January 21, 2020. CORONAVIRUS. “The Centers for Disease Control and Prevention on Tuesday confirmed the first U.S. case of a deadly new coronavirus that has killed six people in China.”
PART 2. January 29, 2020. CORONAVIRUS. “If it’s not contained shortly, I think we are looking at a pandemic..”….. “With isolated cases of the dangerous new coronavirus cropping up in a number of states, public health officials say it is only a matter of time before the virus appears in New York City.”
PART3. February 3, 2020. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)
PART 4. February 9, 2020. Coronavirus. “A study published Friday in JAMA found that 41% of the first 138 patients diagnosed at one hospital in Wuhan, China, were presumed to be infected in that hospital.….
PART 5. February 12, 2020. CORONAVIRUS. “In short, shoe-leather public health and basic medical care—not miracle drugs—are generally what stop outbreaks of emerging infections..”
POST 6. February 18, 2020. Coronovirus. “Amid assurances that the (ocean liner) Westerdam was disease free, hundreds of people disembarked in Cambodia…” “ One was later found to be infected”…. “Over 1,000… passengers were in…transit home”…. “This could be a turning point””
PART 7. February 20, 2020. CORONAVIRUS. With SARS preparedness underway in NJ LibertyHealth/ Jersey City Medical Center, where I was President, proposed that our 100 bed community hospital with all single-bedded rooms, be immediately transformed into an EMERGENCY SARS ISOLATION Hospital.
PART 8. February 24, 2020. CORONAVIRUS. “…every country’s top priority should be to protect its health care workers. This is partly to ensure that hospitals themselves do not become sites where the coronavirus is spread more than it is contained.”
PART 9. February 27, 2020. CORONAVIRUS. Responding to a question about the likelihood of a U.S. outbreak, President Trump said, “I don’t think it’s inevitable…”It probably will. It possibly will,” he continued. “It could be at a very small level, or it could be at a larger level.”
Part 10. March 1, 2020. CORONAVIRUS. Stop Surprise Medical Bills for Coronavirus care. (&) Lessons Learned (or not) In California and Washington State from community acquired cases.
PART 11. March 5, 2020. CORONAVIRUS. “Gov. Andrew Cuomo… would require employers to pay workers and protect their jobs if they are quarantined because of the coronavirus.”
Part 12. March 10, 2020. CORONAVIRUS. “Tom Bossert, Donald Trump’s former homeland security advisor…(said) that due to the coronavirus outbreak, “We are 10 days from the hospitals getting creamed.”
Part 13.. March 14, 2020. CORONAVIRUS. “If I’m buying real estate in New York, I’ll listen to the President….If I’m asking about infectious diseases, I’m going to listen to Tony Fauci,”
PART 14. March 17, 2020. CORONAVIRUS. “ “Most physicians have never seen this level of angst and anxiety in their careers”…. One said “I am sort of a pariah in my family.”
PART 15. March 22, 2020. CORONAVIRUS. “…Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration….in a series of exercises that ran from last January to August.
PART 16. March 27, 2020. CORONAVIRUS. I am not a clinician or a medical ethicist but articles on Coronavirus patient triage started me Googling………to learn about FUTILE TREATMENT
PART 17. April 2, 2020. CORONAVIRUS. Florida allows churches to continue holding services. Gun stores deemed “essential.” “New York’s private and public hospitals unite to manage patient load and share resources.
PART 18. April 9, 2020. CORONAVIRUS. “The federal government’s emergency stockpile of personal protective equipment (PPE) is depleted, and states will not be receiving any more shipments, administration staff told a House panel.
PART 19. April 13, 2020 CORONOAVIRUS. “…overlooked in the United States’ halting mobilization against the novel coronavirus: the personal aides, hospice attendants, nurses and occupational or physical therapists who deliver medical or support services to patients in their homes.”
POST 22. April 29, 2020. CORONAVIRUS. ..the “ACS released a list of 10 issues that should be addressed before a healthcare organization resumes elective surgeries[JM1] ….”
POST 23. May 3, 2020. CORONAVIRUS. … what Dr. Fauci really wants,…”is just to go to a baseball game. That will have to wait. The level of testing for the virus is not adequate enough to allow for such mass gatherings.’ (K)
POST 24. May 7, 2020. CORONAVIRUS. Former New Jersey governor Chris Christie said: “there are going to be deaths no matter what”… but that people needed to get back to work.
POST 25. May 10, 2020, CORONAVIRUS. “It is scary to go to work,” said Kevin Hassett, a top economic adviser to the president. “I think that I’d be a lot safer if I was sitting at home than I would be going to the West Wing.”
POST 26. May 14, 2020. CORONAVIRUS, “Deep cleaning is not a scientific concept”….”there is no universal protocol for a “deep clean” to eradicate the coronavirus”
POST 27. May 19, 2020. CORONAVIRUS. “Hospital…executives…are taking pay cuts…to help offset the financial fallout from COVID-19.” As “front line” layoffs and furloughs accelerate…
POST 28. May 23, 2020. CORONAVIRUS. ““You’ve got to be kidding me,”..”How could the CDC make that mistake? This is a mess.” CDC conflates viral and antibody tests numbers.
PART 29. May 22, 2020. CORONAVIRUS. “The economy did not close down. It closed down for people who, frankly, had the luxury of staying home,” (Governor Cuomo). But not so for frontline workers!
POST 30. June 3,202. CORONAVIRUS. “The wave of mass protests across the United States will almost certainly set off new chains of infection for the novel coronavirus, experts say….
Post 32. June 16, 2020. CORONAVIRUS. Could the Trump administration be pursuing herd immunity by “inaction”? “ If Fauci didn’t exist, we’d have to invent him.”
POST 34. June 26, 2020. CORONAVIRUS. CDC Director Redfield… “the number of coronavirus infections…could be 10 times higher than the confirmed case count — a total of more than 20 million.” As Florida, Texas and Arizona become eipicenters!
POST 35. June 29, 2020. CORONAVIRUS. Pence: “We slowed the spread. We flattened the curve. We saved lives..” While Dr. Fauci “warned that outbreaks in the South and West could engulf the country…”
POST 36. July 2, 2020. CORONAVIRUS. “There’s just a handful of interventions proven to curb the spread of the coronavirus. One of them is contact tracing, and “it’s not going well,” (Dr. Anthony Fauci)..
POST 37. June 8, 2020. CORONAVIRUS. When “crews arrive at a hospital with a patient suspected of having COVID-19, the hospital may have a physical bed open for them, but not enough nurses or doctors to staff it.”
POST 38. July 15, 2020. CORONAVIRUS. Some Lessons Learned, or not. AdventHealth CEO Terry Shaw: I wouldn’t hesitate to go to Disney as a healthcare CEO — based on the fact that they’re working extremely hard to keep people safe,” (M)
POST 39. July, 23,2020. CORONAVIRUS. A Tale of Two Cities. Seattle becomes New York (rolls back reopening) while New York becomes Seattle (moves to partial phase 4 reopening)
POST 40. July 27, 2020. CORONAVIRUS.” One canon of medical practice is that you order a test only if you can act on the result. And with a turnaround time of a week or two, you cannot. What we have now is often not testing — it’s testing theater.”
POST 41. August 2, 2020. CORONAVIRUS. “Whenever a vaccine for the coronavirus becomes available, one thing is virtually certain: There won’t be enough to go around. That means there will be rationing.”
POST 44. September 1, 2020. CORONAVIRUS. “The CDC…modified its coronavirus testing guidelines…to exclude people who do not have symptoms of Covid-19.” (While Dr. Fauci was undergoing surgery.) A White House official said: “Everybody is going to catch this thing eventually..”
POST 45. September 9, 2020. CORONAVIRUS. Trump on Fauci. ‘You inherit a lot of people, and you have some you love, some you don’t. I like him. I don’t agree with him that often but I like him.’
POST 46. September 17, 2020. CORONAVIRUS. “Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore. And he doesn’t trust the Centers for Disease Control and Protection either….”
POST 47. September 24, 2020. CORONAVIRUS. “Perry N. Halkitis, dean of the School of Public Health at Rutgers University…called New York City’s 35 percent rate for eliciting contacts “very bad.” “For each person, you should be in touch with 75 percent of their contacts within a day,” he said”
“President Donald Trump continues to baselessly claim the coronavirus will simply “go away” even as the number of COVID-19 cases in the U.S. skyrocket under an administration fumbling its response to the pandemic.
“This is going to go away,” Trump said of the deadly virus at the White House on Tuesday. “And whether it comes back in a modified form in the fall, we’ll be able to handle it, we’ll be able to put out spurts, and we’re very prepared to handle it.”..
“It’s going to disappear,” he said of the coronavirus at the time as infection numbers began to trickle in. “One day it’s like a miracle, it will disappear.”” (J)
“Bill Gates used to think of the US Food and Drug Administration as the world’s premier public-health authority. Not anymore.
And he doesn’t trust the Centers for Disease Control and Protection either.
Both, in his view, are casualties of a presidency that has downplayed or dismissed science and medicine in the pursuit of political gain. One recent example came when FDA Commissioner Stephen Hahn, speaking at one of President Donald Trump’s news conferences, exaggerated the benefit of blood plasma as a treatment for Covid-19, then backtracked the following day.
“We saw with the completely bungled plasma statements that when you start pressuring people to say optimistic things, they go completely off the rails. The FDA lost a lot of credibility there,” Gates, the billionaire philanthropist, said in an interview on Bloomberg Television.
“Historically, just like the CDC was viewed as the best in the world, the FDA had that same reputation as a top-notch regulator,” Gates said. “But there’s been some cracks with some of the things they’ve said at the commissioner level.”
At stake is nothing less than public confidence in the vaccine that could end the coronavirus pandemic, and which the FDA would have to approve. Polls conducted in the past two months show a majority of Americans worry development of the vaccine is being rushed and a third wouldn’t get inoculated.” (A)
“In an interview with STAT, Gates sounded exasperated at times as he described the badly bungled launch of Covid-19 testing, the enlisting of a neuroradiologist — rather than an epidemiologist or infectious diseases specialist — to help guide the White House’s response decisions, and the recent move to discourage testing of people who have been in contact with a known case but who aren’t yet showing symptoms.
“You know, this has been a mismanaged situation every step of the way,” Gates said in the wide-ranging interview. “It’s shocking. It’s unbelievable — the fact that we would be among the worst in the world.”
He leveled his harshest criticism at Food and Drug Administration Commissioner Stephen Hahn, who mischaracterized findings from a Mayo Clinic study on Covid-19 and said researchers had seen a 35% survival benefit with the use of convalescent plasma. “Many of you know I was a cancer doctor before I became FDA commissioner,” Hahn said at the time. “And a 35% improvement in survival is a pretty substantial clinical benefit.”
“This is third grade math. I mean, are you kidding?” Gates said. “The head of the FDA got up and said it was a 35% death reduction where it’s not even a 3% reduction based on just a tiny little subset that was nonstatistical. This is unheard of.”…
Early in the outbreak, as it was becoming clear the new coronavirus was spreading from China, experts from the Bill and Melinda Gates Foundation were in regular contact with the Trump administration, urging officials to come up with a plan for who to test and how to test them, and to get surveillance data up on the website of the Centers for Disease Control and Prevention.
Gates said from the start the foundation insisted that commercial laboratories should only be paid for their work if they returned test results within 24 hours — a target rarely reached in the U.S. response. Anything longer than that meant the tests were not useful for containing spread of the virus, he said, adding: “You get to write apology notes to the people you infected in the meantime.”
This advice still isn’t being heeded. “I’ve been saying this and I just don’t get why it hasn’t changed,” Gates said.
The CDC’s early missteps on testing — “they created this overly complicated test,” Gates said — was followed by a slow rollout of commercial tests. The commercial tests use polymerase chain reaction, or PCR, to look for small fragments of the genetic material of the virus in mucus swabbed out of the nasal passages of people who are tested.
“We have way more PCR machines than any country in the world. I mean, we are PCR central,” he said with emphasis. “So, the idea that we actually made it harder to get PCR tests approved by the commercial sector, it’s mind-blowing.”..
Likewise, Gates could not believe the administration’s recent move to rewrite CDC testing guidance to state that people who weren’t displaying symptoms didn’t need to be tested. Experts said the revised recommendations will make it harder to find and isolate people who are just becoming infectious — undermining efforts to limit spread of the virus. “It blows the mind,” Gates said.
The new advice reportedly had the support of Scott Atlas, a recent addition to the White House coronavirus task force. Atlas, a neuroradiologist and a public policy fellow at Stanford University’s Hoover Institution, has reportedly been advocating a policy of allowing the virus to spread unchecked so the country can reach herd immunity quicker.
Gates is not a fan. “The administration’s now hired this Stanford guy who has no background at all just because he agrees with their crackpot theories.” “ (B)
“The health department’s politically appointed communications aides have demanded the right to review and seek changes to the Centers for Disease Control and Prevention’s weekly scientific reports charting the progress of the coronavirus pandemic, in what officials characterized as an attempt to intimidate the reports’ authors and water down their communications to health professionals.
In some cases, emails from communications aides to CDC Director Robert Redfield and other senior officials openly complained that the agency’s reports would undermine President Donald Trump’s optimistic messages about the outbreak, according to emails reviewed by POLITICO and three people familiar with the situation.
CDC officials have fought back against the most sweeping changes, but have increasingly agreed to allow the political officials to review the reports and, in a few cases, compromised on the wording, according to three people familiar with the exchanges. The communications aides’ efforts to change the language in the CDC’s reports have been constant across the summer and continued as recently as Friday afternoon.
The CDC’s Morbidity and Mortality Weekly Reports are authored by career scientists and serve as the main vehicle for the agency to inform doctors, researchers and the general public about how Covid-19 is spreading and who is at risk. Such reports have historically been published with little fanfare and no political interference, said several longtime health department officials, and have been viewed as a cornerstone of the nation’s public health work for decades.
But since Michael Caputo, a former Trump campaign official with no medical or scientific background, was installed in April as the Health and Human Services department’s new spokesperson, there have been substantial efforts to align the reports with Trump’s statements, including the president’s claims that fears about the outbreak are overstated, or stop the reports altogether.
Caputo and his team have attempted to add caveats to the CDC’s findings, including an effort to retroactively change agency reports that they said wrongly inflated the risks of Covid-19 and should have made clear that Americans sickened by the virus may have been infected because of their own behavior, according to the individuals familiar with the situation and emails reviewed by POLITICO.
Caputo’s team also has tried to halt the release of some CDC reports, including delaying a report that addressed how doctors were prescribing hydroxychloroquine, the malaria drug favored by Trump as a coronavirus treatment despite scant evidence. The report, which was held for about a month after Caputo’s team raised questions about its authors’ political leanings, was finally published last week. It said that “the potential benefits of these drugs do not outweigh their risks.”
In one clash, an aide to Caputo berated CDC scientists for attempting to use the reports to “hurt the President” in an Aug. 8 email sent to CDC Director Robert Redfield and other officials that was widely circulated inside the department and obtained by POLITICO….
CDC officials have fought the efforts to retroactively change reports but have increasingly allowed Caputo and his team to review them before publication, according to the three individuals with knowledge of the situation. Caputo also helped install CDC’s interim chief of staff last month, two individuals added, ensuring that Caputo himself would have more visibility into an agency that has often been at odds with HHS political officials during the pandemic….
But public health experts told POLITICO that they were particularly alarmed that the CDC’s reports could face political interference, praising the MMWRs as essential to fighting the pandemic.
“It’s the go-to place for the public health community to get information that’s scientifically vetted,” said Jennifer Kates, who leads the Kaiser Family Foundation’s global health work. In an interview with POLITICO, Kates rattled off nearly a dozen examples of MMWR reports that she and other researchers have relied on to determine how Covid-19 has spread and who’s at highest risk, including reports on how the virus has been transmitted in nursing homes, at churches and among children.
“They’re so important, and CDC has done so many,” Kates said…
Caputo defended his team’s interventions as necessary to the coronavirus response. “Buried in this good [CDC] work are sometimes stories which seem to purposefully mislead and undermine the President’s Covid response with what some scientists label as poor scholarship — and others call politics disguised in science,” Caputo told POLITICO.
The battles over delaying or modifying the reports have weighed on CDC officials and been a distraction in the middle of the pandemic response, said three individuals familiar with the situation. “Dr. Redfield has pushed back on this,” said one individual. “These are scientifically driven articles. He’s worked to shake some of them loose.”
Kates, the Kaiser Family Foundation’s global health expert, defended the CDC’s process as rigorous and said that there was no reason for politically appointed officials to review the work of scientists. “MMWRs are famously known for being very clear about their limitations as well as being clear for what they’ve found,” she said.
Kates also said that the CDC reports have played an essential role in combating epidemics for decades, pointing to an MMWR posted in 1981 — the first published report on what became the HIV epidemic.
“Physicians recognized there was some kind of pattern and disseminated it around the country and the world,” Kates said. “We can now see how important it was to have that publication, in that moment.”” (C)
“White House officials are advising Dr. Anthony Fauci, the nation’s top infectious disease expert, to promote messages that prioritize political positions over scientific findings, an attempt to bolster Donald Trump’s misleading claims about the coronavirus. The pressure is apparently coming from Paul Alexander, a Trump appointee at the Department of Health and Human Services who, in emails reported by Politico, has repeatedly tried to edit Fauci’s planned responses to outlets including Bloomberg News, BuzzFeed, HuffPost, and the science journal Cell. Just this week, Alexander reportedly sent a message to Fauci’s press team urging him not to promote mask-wearing by children in an MSNBC interview.
“Can you ensure Dr. Fauci indicates masks are for the teachers in schools. Not for children,” Alexander wrote. “There is no data, none, zero, across the entire world, that shows children especially young children, spread this virus to other children, or to adults or to their teachers. None. And if it did occur, the risk is essentially zero,” he said, adding—without evidence—that children “take influenza home but do not take COVID home.” The advice prompted long email threads between Alexander and some of Fauci’s aides pushing back against the misleading claims. Alexander is a senior adviser to Michael Caputo, an ally of the president who currently oversees HHS’s media strategy and who said in a statement that he “hired Dr. Alexander for his expertise and not to simply resonate others’ opinions.”…
Fauci told Politico he had not seen the emails, nor had his staff advised him to minimize the risk coronavirus poses to kids or the need for mask-wearing. “No one tells me what I can say and cannot say,” Fauci said. “I speak on scientific evidence,” a point he reiterated in a pair of interviews on Friday. Asked by CNN’s Wolf Blitzer whether the public should listen to Fauci or Trump—who on Thursday claimed “we’re rounding the corner” of the pandemic—Fauci remarked, “You don’t have to listen to any individual” if you “look at the data. The data speak for themselves,” he said. “We’re still getting up to 40,000 new infections a day and 1,000 deaths. That is what you look at. Look at the science, the evidence and the data and you can make a pretty easy conclusion.” (D)
“Current and former senior health officials with direct knowledge of phone calls, emails and other communication between the agencies confirmed on Saturday a report in Politico late Friday that the C.D.C.’s public Morbidity and Mortality Weekly Reports have been targeted by senior officials in the Health and Human Services’ communications office.
The reports, which one former top health official called the “holiest of the holy” in agency literature, are written largely for scientists and public health experts, to update them on trends in infectious diseases, not only the coronavirus but also other outbreaks around the country. They are guarded so closely by agency staff members that political appointees only see them just before they are published.
The reports became the subject of intense scrutiny this summer by Michael Caputo, a Republican political operative and former Trump campaign official the White House installed as the top spokesman at the department in April, despite his having no background in health.
Mr. Caputo himself said on Saturday that Politico’s report was largely accurate, but he denied that there was any overt pressure involved. He said that the primary person involved in critiquing the reports, Paul Alexander, an assistant professor of health research at McMaster University in Canada whom he hired to advise him on the science of the pandemic, simply offered direct reactions to the drafts of the C.D.C.’s Morbidity and Mortality Weekly Reports.
“He digs into these M.M.W.R.s and makes his position known, and his position isn’t popular with the career scientists sometimes,” Mr. Caputo said of Dr. Alexander. “That’s called science. Disagreement is science. Nobody has been ever ordered to do anything. Some changes have been accepted, most have been rejected. It’s my understanding that that’s how science is played.”
In an email obtained by Politico and confirmed to The Times by a health official with direct knowledge of the message, Dr. Alexander accused C.D.C. scientists of trying to “hurt the president,” referring to the weekly reports as “hit pieces on the administration.” Dr. Alexander asked Dr. Robert R. Redfield, the C.D.C. director, to edit reports that had already been published, which he believed overstated the risks of the virus for children and undermined the administration’s efforts to encourage school reopenings.
The meddling from Washington concerned Dr. Redfield, according to one former senior health official, who often pushed back when Mr. Caputo called to pester him about the reports.” (E)
“The MMWR Weekly reports are authored by scientists and published by the CDC. Their purpose is to inform doctors, medical professionals and researchers and offer statistics, data and trends on all aspects of health issues in the United States. The MMWR Weekly report is also in the public domain and can be reprinted without permission – all reports dating back to 1982 are available on the CDC’s online database. Notable MMWR Weekly articles included a report on AIDS in 1981 and an alert on lead-contaminated drinking water in Washington in 2001. The MMWR Weekly reports have always been published without any kind of interference from political parties – until now.
Caputo, a former Republican operative who comes from neither a medical nor a scientific background, has allegedly modified MMWR reports to play down the health risks associated with Covid-19 or sometimes block certain articles from being included at all. In an email sent to CDC Director Robert Redfield which Politico has gained access to, Paul Alexander, a member of Caputo’s team accused CDC scientists of deliberately using the reports “as hit pieces to hurt the President”. In the same email, Alexander asked Redfield to make changes to two reports which had already been published online, claiming that they were “misleading” and wrongly inflated Coronavirus’ risks to children – consequently hindering Trump’s plans to reopen schools.
Alexander also requested that publication of all future MMWR reports should be halted “immediately” adding that the publication process should be completely revamped to enable him to review and edit reports before they were published. “The reports must be read by someone outside of CDC like myself; and we cannot allow the reporting to go on as it has been, for it is outrageous. Its lunacy,” Alexander wrote in one email to Redfield. “Nothing to go out unless I read and agree with the findings how they CDC, wrote it and I tweak it to ensure it is fair and balanced and complete”.
When Politico approached Caputo to ask why he and his team were demanding changes to MMWR reports, Caputo responded with a statement in which he heaped praise on Alexander, who he hailed as “an Oxford-educated epidemiologist who specializes in analysing the work of other scientists”.” (F)
“Scientists and physicians reacted with words such as “aghast,” “despicable” and “outrageous” over the weekend as news spread that White House appointees interfered with a basic national public health report when it conflicted with President Donald Trump’s coronavirus messaging.
Michael Caputo, the Health and Human Services assistant secretary for public affairs, acknowledged Saturday that since June, he and an adviser have scrutinized and at times pushed for changes to a weekly health report distributed by the U.S. Centers for Disease Control and Prevention.
The meddling, first reported by Politico, included efforts to stop the publication of a report last week on the use of hydroxychloroquine, a malaria drug often touted by Trump, delay a 10-state study of COVID-19 infection statistics in June and another on the spread of coronavirus at a Georgia sleep-away camp….
The Morbidity and Mortality Weekly Report is a series of dry and sometimes dense brief updates on public health incidents that come out on Thursdays. They typically describe events or topics and are an important way for doctors and health officials to get the latest data.
Dr. William Schaffner, who is on the publication’s editorial board, said he was “aghast” and “appalled” by the reported attempts to delay, stop or change reports. He described the publication as a vital part of the global conversation among public health officials who track diseases and dangers.
“It has been the voice of the U.S. government’s health system, of integrity and scientific rigor, for years,” said Schaffner, a professor and infectious disease expert at the Vanderbilt University School of Medicine in Nashville, Tennessee. “Indeed, the MMWR has been a model for other countries’ ministries of public health for creating similar newsletters in their countries.”
The interference is not just anti-science but disinformation intended to deceive the American public, said Dr. Eric Topol, a professor of molecular medicine at the Scripps Research Institute in La Jolla, California.
“This is outright egregious. It’s despicable,” Topol said, accusing Redfield and other leaders of allowing the agency to be hijacked by politics.
“What we’re seeing is multiple actors, important people who are just laying down, who are complicit with the anti-science machinations of the Trump administration,” he said….
On Twitter, Dr. Sherri Bucher, a global health researcher, wrote, “There are no words to articulate how horrific this is. Trust & credibility, shattered, overnight. MMWR has been, for a long time, one of the most reliable, steadfast, scientific resources; unquestioned veracity, impeccable reputation for quality of data/analysis. No longer.”” (G)
“On Saturday, members of the public health community aired frustration over the report, which has not been confirmed by CNBC. Dr. Carlos Del Rio, an infectious disease specialist at Emory University, called the reports “incredibly concerning.”
“It’s very upsetting also for those of us in public health and medicine. The MMWR is a landmark CDC publication,” he said in an interview with CNN’s Fredricka Whitfield. “I think that MMWR are still trying to get the information out there, but certainly now, I will start reading with a degree of skepticism.”
Marc Lipsitch, an epidemiologist at Harvard University, said on Twitter that the move is “outrageous and dangerous” to public trust in the CDC. He added that the move is “unsurprising.”..
Dr. Atul Gawande, a professor in the Department of Health Policy and Management at Harvard, said on Twitter that political appointees “should have no role in scientific publications. None.”
Natalie Dean, a biostatistician at the University of Florida, urged the Trump administration to give career professionals at the CDC more freedom so speak.
“It remains unthinkable to me that during a global pandemic that has so severely impacted the United States, we hear so little from the CDC,” she said on Twitter. “The expertise is there. Let the scientists speak.”
Through MMWR, the CDC has continued to regularly publish important studies about Covid-19, including one this week that emphasized the risk of spread associated with dining at a restaurant and another demonstrating kids’ ability to spread the virus despite not becoming severely sick with the disease.
HHS Secretary Alex Azar, in a statement to CNBC, said Trump has always been receptive to “the data and science.” The CDC falls under the responsibility of HHS.
“As the Secretary of Health and Human Services, I have briefed President Trump alongside the nation’s top doctors and I have insisted that he have direct access to these doctors throughout the COVID-19 pandemic,” Azar said. “He has always been receptive to the data and science presented by me and other members of the task force. President Trump’s science-based decision making has saved lives.”” (H)
“As acting director of the CDC at the dawn of the H1N1 pandemic in 2009, I felt the natural tensions that can occur between political appointees and career public health officials at CDC. During my tenure, the science was always—without exception—the driving force in the review process and in our communications to the public. Indeed, in the many decades I’ve spent in public health, including 13 years at CDC, science has been the arbiter of truth and carried the day no matter the administration or the political party. That must remain the case today.
The MMWR is among the most sober and least political public health communiques one can imagine. The name itself—Mortality and Morbidity Weekly Report—could only have been conceived by scientists rather than professional communicators. I’ve reviewed hundreds and co-authored several of these reports, which are notoriously meticulous, built on foundations of data and notably devoid of adjectives. The just-the-facts approach could be frustrating, in fact, because any public health guidance that carried even a whiff of the subjective would be expunged from the reports by science-driven editors. This is as it should be for public health communications written for the public health community, and it’s why the integrity of these reports has been second to none.
In 2009, the first communications from CDC about H1N1 were included in the MMWR. Two cases in California detailed in an MMWR in April of that year gave us an early indication that the virus first reported in Mexico had crossed into the United States. From that point forward—much as we’re seeing today—the MMWRs would serve as a valuable tool in filling in the gaps in knowledge while informing public health officials in every state in the country, and in real time, what they might be facing. These reports are the keepers of the latest statistics and allow for sharing of information to be used in planning and response during a public health crisis.
Because the voice of the CDC has largely been silenced during the coronavirus pandemic and unable to regularly reach the public, the MMWRs have become an even more critical conduit for the latest information and data. Produced like clockwork and driven by scientific rigor, they have detailed everything from COVID-19 spread at church events to outbreaks among college students to a comprehensive look at who is dying from COVID-19 in the U.S. The latest report, issued the day the Politico story broke, detailed COVID-19 outbreaks at three Utah childcare facilities. Each report is an important puzzle piece in helping on-the-ground public health officials better understand the virus and emerging epidemiological learnings….
The landmark of 200,000 deaths that is fast approaching reflects a scale of tragedy that the United States did not have to bear. CDC science should not be undermined nor the voices of its experts muted, or our nation will suffer a crisis of confidence and trust that will continue to hamper our recovery from this pandemic and open the door for more death and more suffering.
We cannot let this happen.” (I)
“Testifying before Congress on Wednesday, Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, strongly disputed that his agency’s scientific research has been influenced by political appointees attempting to bring those findings in line with President Trump’s views.
“We’re not going to let political influence try to modulate” the agency’s scientific conclusions, Redfield said. Those conclusions are customarily conveyed in a regular CDC publication called the Morbidity and Mortality Weekly Report, or MMWR…
“The scientific integrity of the MMWR has not been compromised,” Redfield said in his Senate testimony on Wednesday. “It will not be compromised on my watch.” He added that he would “stand by” his agency’s “scientific experts” and ensure that their work is free of political taint.” (K)
“President Trump on Wednesday rejected the professional scientific conclusions of his own government about the prospects for a widely available coronavirus vaccine and the effectiveness of masks in curbing the spread of the virus as the death toll in the United States from the disease neared 200,000.
In a remarkable display even for him, Mr. Trump publicly slapped down Dr. Robert R. Redfield, the director of the Centers for Disease Control and Prevention, as the president promised that a vaccine could be available in weeks and go “immediately” to the general public while diminishing the usefulness of masks despite evidence to the contrary.
The president’s comments put him at odds with the C.D.C., the world’s premier public health agency, over the course of a pandemic that he keeps insisting is “rounding the corner” to an end. Mr. Trump lashed out just hours after Dr. Redfield told a Senate committee that a vaccine would not be widely available until the middle of next year and that masks were so vital in fighting the disease caused by the coronavirus, Covid-19, that they may even more important than a vaccine….
The public scolding of Dr. Redfield was only the latest but perhaps the starkest instance when the president has rejected not just the policy advice of his public health officials but the facts and information that they provided. Public health officials are in strong agreement about the value of masks even as Mr. Trump generally refuses to wear one, mocks his opponent for doing so and twice in the past two days questioned their utility based on the advice of restaurant waiters.” (L)
